戒断时程对甲基苯丙胺依赖者冲动性选择与渴求的影响

目的本研究旨在探讨不同戒断时间的甲基苯丙胺依赖者冲动性选择、非诱导性渴求及药物相关环境线索诱导的渴求的变化规律。方法采用爱荷华赌博任务(IowaGambling Task)对戒断6天(6 d),14天(14 d),1个月(1m),3个月(3 m),6个月(6 m)和1年(1 y)的甲基苯丙胺依赖者以及正常对照者的冲动性选择进行评估;给予戒断6 d,14 d,1 m,3 m,6 m和1 y的甲基苯丙胺依赖者中性和药物相关线索暴露,在线索给予之前和之后采用视觉模拟尺分别进行渴求评分。结果随戒断时间的延长,甲基苯丙胺依赖者的冲动性选择呈现逐渐恢复的过程;甲基苯丙胺短期戒断组(6 d,14 d,1 m和3 m)的决策能力都有损伤,但6 m与12 m两组与正常对照已无显著差异。在未给予药物相关线索之前,甲基苯丙胺依赖者的渴求随戒断时间的延长而下降;在戒断3 m之前,有效的药物线索暴露诱导的渴求随戒断时间的延长而增加,而在戒断6 m和1 y时有所回落。结论甲基苯丙胺依赖者戒断后,随戒断时间的延长,冲动性选择与非诱导性渴求趋于改善,但药物相关环境线索诱导的渴求存在"潜伏"现象,这提示药物相关环境线索诱导的渴求所引起的复吸风险可能随着戒断持续存在或者增加。     

甲基苯丙胺使用戒毒人员的冲动性及相关因素分析

目的 了解甲基苯丙胺使用戒毒人员的冲动性,探索其相关因素,为预防冲动暴力事件以及更好地管理戒毒人员提供帮助。方法 纳入2019年6月—2019年12月期间因吸食甲基苯丙胺戒毒的人员,经知情同意后,采用自制简表,了解其一般情况包括性别、年龄、身高、体重、职业、婚姻状况、居住地、是否独生子女等,评估其精神症状,是否吸烟、饮酒,评估Barratt冲动性量表(Barratt Impulsivity Scale, BIS-11)。采用EpiData 3.1建立数据库,运用SPSS 22.0软件进行统计分析,连续性变量用均数±标准差表示,分类变量用计数和百分比表示,将BIS-11量表得分及各分量表得分与常模比较,并将其与一般情况、物质使用情况、吸烟、饮酒及精神症状等做相关性分析,P<0.05差异有统计学意义。结果 甲基苯丙胺使用者的冲动性高于普通人群(t=7.67,P=0.00),主要表现为非计划冲动及认知冲动。年龄与行动冲动呈负相关(γ=-0.155,P=0.038),教育水平与冲动总分呈负相关(γ=-0.158,P=0.036),其余包括BMI、职业、婚姻状况、居住地、是否独生子女、物质...     

甲基苯丙胺及海洛因依赖者认知功能损伤的特征

目的:本研究旨在了解甲基苯丙胺(methamphetamine,MA)依赖者及海洛因依赖者的认知功能特征。方法:研獉獉獉獉究招募38名MA依赖者、22名海洛因依赖者、32名健康对照,所有受试者完成计算机化的综合认知量表(CogS tate量表)测试,同时收集受试者人口学资料及药物滥用史。结果:在工作记忆任务、执行功能任务中,MA组的表现与海洛獉獉因组的任务表现无差异(P>0.05),但两组任务表现都差于健康对照组(P<0.05)。在言语记忆任务、认知情绪认知任务中,MA组表现差于海洛因组及健康对照组(P<0.05),但海洛因组与健康对照组无差异(P>0.05)。结论:MA獉獉依赖者及海洛因依赖者都存在工作记忆、执行功能损伤,但MA依赖者呈现更多领域的认知损伤(言语记忆、社会认知),提示两种物质依赖者认知功能损伤存在异同,将来需要开发具有针对性的物质依赖康复方法。     

海洛因依赖者和甲基苯丙胺依赖者睡眠状况研究

目的:分析海洛因依赖者和甲基苯丙胺(methamphetamine,MA)依赖者的睡眠问题及差异。方法:采用匹兹赖者和962名MA依赖者的睡眠质量进行调查研究。结果:吸毒者PSQI总分为7. 92±4. 45(分),其中海洛因依赖组为9. 18±4. 05(分),MA依赖组为6. 60±4. 48(分);海洛因依赖组PSQI总分高于MA依赖组,差异具有显著的统计学意义(P <0. 001)。吸毒者出现睡眠问题的比率为67. 5%(PSQI> 5),其中海洛因依赖组为80. 0%(n=810),MA依赖组为54. 3%(n=522);海洛因依赖组出现睡眠问题的比率明显高于MA依赖组,差异具有显著的统计学意义(P <0. 001)。结论:两组吸毒者的睡眠质量均较差,而且两组均超过一半的吸毒者存在睡眠问题。与MA依赖组比较,海洛因依赖组的睡眠质量更差,出现睡眠问题的比率更高。临床工作中应注重对吸毒人员睡眠问题的评估,改善吸毒者睡眠问题,有利于提高戒毒疗效,减少毒品复吸。     

冲动性对海洛因依赖者HCV感染的影响

目的:探讨冲动性对海洛因依赖者HCV感染的影响,提供HCV感染的干预策略。方法:采用贝克焦虑量表(Beck Anxiety Inventory,BAI)、贝克抑郁量表(Beck Depression inventory,BDI)和BIS-11(中文版)对重庆市渝北区第二人民医院在治的463名海洛因依赖者进行问卷调查,并收集血液样本进行HCV抗体的血清学检测。结果:在接受调查的海洛因依赖者中,HCV阳性检出率为69.76%;吸毒方式和共用针具在HCV感染与否具有显著的组间差异(P<0.001);HCV阳性组依赖者焦虑、抑郁得分(P<0.05)、冲动性得分(P<0.001)均显著更高;二分类Logistic回归分析结果表明,婚姻状况、冲动性是HCV感染的高危因子。结论:重庆市渝北区在治的海洛因依赖者HCV感染率较高,HCV感染者的焦虑、抑郁和冲动性水平显著增高,婚姻状况和冲动性在HCV感染中起重要作用。应加强海洛因依赖者中HCV感染者的社会心理干预和冲动管理。     

度洛西丁对甲基苯丙胺依赖者情绪障碍的疗效观察

目的:探讨度洛西丁对甲基苯丙胺依赖者情绪障碍的治疗效果。方法:对103例甲基苯丙胺依赖戒断者在成功脱瘾后的一周内,测查汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)。将103例患者随机分为对照组(n=51)和药物处理组(n=52),对照组仅给予简单的言语解释和支持,药物处理组给度洛西丁60 mg.d-1治疗。6周后复查HAMA和HAMD量表,评定治疗效果。结果:甲基苯丙胺依赖戒断者均有明显的焦虑、抑郁等情绪障碍。连续给予度洛西丁治疗6周后,HAMA、HAMD评分较对照组明显下降,有显著统计学差异(P<0.01)。结獉论獉:对甲基苯丙胺依赖戒断者脱瘾后早期使用度洛西丁干预,可缓解其情绪障碍,可能有利于防止复吸。     

针灸治疗甲基苯丙胺依赖者戒断综合征的meta分析

目的 运用meta分析方法系统评价针灸对于甲基苯丙胺(methamphetamine, MA)依赖者戒断综合征的临床疗效。方法 通过系统检索中国知网(CNKI)、万方(WANFANG)、维普数据库(VIP)和中国生物医学数据库(CBM),PubMed、Cochrane Library数据库自建库到2020年5月所有关于针灸治疗MA依赖者戒断综合征的随机对照临床试验(randomized clinical trial, RCT)文献。由两名研究者根据文献的纳排标准对文献进行筛选,用Cochrane协作网对文献作文献质量评价,运用RevMan5.3软件对文献进行meta分析。结果 共纳入13篇文献,纳入病例总数为851例,meta分析结果显示,与对照组相比,针灸可有效改善焦虑症状[MD=-5.50,95%CI(-5.75,-5.25),P<0.00001],有效改善抑郁症状[MD=-10.26,95%CI(-10.68,-9.85),P<0.00001],有效改善戒断症状[MD=-3.97,95%CI(-5.88,-2.05),P<0.0001],有效改善失眠症状[MD=...     

甲基苯丙胺、海洛因依赖者的子宫、卵巢超声特征分析

目的：分析甲基苯丙胺、海洛因依赖者子宫、卵巢超声特征,探究长期使用甲基苯丙胺、海洛因对女性生殖系统的损害,为临床诊疗提供解剖依据。方法：回顾性分析2019年1月—2022年7月因滥用甲基苯丙胺、海洛因在我院进行强制戒毒的女性,其中甲基苯丙胺依赖者79人作为甲基苯丙胺组,海洛因依赖者91人作为海洛因组,另外选取本单位健康职工60人作为对照组。所有入组对象均行超声检查,比较三组卵巢大小、子宫大小、卵巢血流参数。结果：甲基苯丙胺组子宫体、双侧卵巢积小于对照组,差异有统计学意义（P<0.05）;海洛因组子宫、双侧卵巢体积小于对照组,差异有统计学意义（P<0.05）;甲基苯丙胺组、海洛因组子宫、双侧卵巢体积比较,差异无统计学意义（P>0.05）。甲基苯丙胺组、海洛因组卵巢动脉血流峰值流速及舒张末期流速低于对照组,阻力指数高于对照组,差异有统计学意义（P<0.05）;甲基苯丙胺组、海洛因组卵巢动脉血流峰值流速、舒张末期流速、阻力指数比较,差异无统计学意义（P>0.05）。结论：海洛因、甲基苯丙胺的长期滥用会导致女性卵巢、子宫形态及卵巢动脉发生明显改变,超声检查可以准确...     

甲基苯丙胺依赖者在戒断28周内心理状况调查分析简

目的獉獉：探究甲基苯丙胺依赖者在戒断毒品的28周内心理状况的变化,以便更细致地了解甲基苯丙胺依赖者的戒断症状。方法獉獉：选取符合入组标准的甲基苯丙胺依赖者组成甲基苯丙胺依赖组（n=96）,以末次吸食为基准点,分别在第2周、第8周、第16周和第28周应用症状自评量表（SCL-90）、汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）对其进行心理状况测试;同时,选取无药物滥用史的健康人群作为正常对照组（n=192）,进行上述3个经典量表的测试。结果獉獉：在强制隔离戒毒期间,3个量表均提示,甲基苯丙胺依赖组分值在第2周最高,此后第8、16、28周分值均有下降趋势,其中第28周分值最低。但在汉密尔顿焦虑量表中,焦虑总分在第16周有小幅升高,且与第8周比较有统计学意义（P〈0.05）。针对3个量表进行相关性分析,3者均呈正相关。结论獉獉：甲基苯丙胺依赖者戒断28周内存在严重的心理和情感问题,在戒断后第2周稽延性戒断症候群最为严重,其中焦虑、抑郁症候群最为显著。在第16周精神状况有小幅波动,此后各心理量表分值均呈现下降趋势。     

海洛因和甲基苯丙胺依赖者自然戒断期免疫功能的研究

目的：通过测量自然戒断两周和半年后戒毒者外周血免疫球蛋白（IgA、IsG、IgM）、补体（c3、C4）及转化生长因子（TGF）-β水平来评价机体的免疫功能。方法：采集戒断两周和半年戒毒者血液各50例,分别采用散射比浊法和ELISA法测定外周血IgA、IsG、IgM、C3、C4和TGF—β含量,并与30例健康体检者（对照组）进行比较。结果：与对照组相比,戒断两周组]gM含量显著增高,IgG、C3含量显著降低,C4未见显著性差异。而戒断半年组IsG、C3、c4含量与对照组相比显著降低,TGF—β含量显著增高,且C4、TGF—β含量低于两周组。Isa各组间未见显著性差异。结论：海洛因和甲基苯丙胺依赖者免疫功能受损,自然戒断半年后有些指标逐渐恢复正常。     

Neurocognitive Profiles of Methamphetamine Users: Comparison of Those With or Without Concomitant Ketamine Use

Objective: Methamphetamine (MAMP) and ketamine are neurotoxic drugs whose chronic use has been linked with a cognitive decline in some users. This paper aims to assess the possible effect of concomitant ketamine use on the neurocognitive performance of MAMP users. Methods: This study divides 42 MAMP users into MAMP users who use ketamine (MAMP+K, n = 16) and MAMP users who do not use ketamine (MAMP–K, n = 26). The performance of these two groups was compared using the Brief Assessment of Cognition in Schizophrenia (BACS), Conners’ Continuous Performance Tests (CPT), the Wisconsin Card Sorting Test (WCST), the Iowa Gambling Task (IGT), and the Barratt Impulsiveness Scale (BIS). Results: In comparison to the MAMP-K group, the MAMP+K group showed worse performances in verbal fluency, executive function and composite score in BACS; worse performances in total errors, perseverative errors, nonperseverative errors and conceptual level response in WCST; and greater levels of total scores and novelty-seeking in BIS. Neither the attention function evaluated with CPT nor the decision-making behavior evaluated with IGT was associated with previous ketamine use. Conclusion: This study detected worse executive function and higher impulsivity level among MAMP users with additional ketamine use versus their counterparts without ketamine use. Further studies with a longitudinal design and a large sample size are necessary to clarify the connection between cognitive deficits and concomitant use of MAMP and ketamine.     

甲基苯丙胺成瘾者戒断期的脑源性神经营养因子变化研究进展

脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)参与了神经发生、神经可塑性及认知功能等多种神经活动,参与学习和记忆的过程,对神经可塑性的调节和损伤后修复具有重要影响,被认为是与成瘾行为相关的生物标志物.本文回顾了国内外BDNF与物质成瘾关系以及甲基苯丙胺成瘾者戒断期外周...     

甲基苯丙胺渴求量表在戒毒人员中应用的信效度

目的:探讨修订版甲基苯丙胺渴求量表(MA craving scale)在甲基苯丙胺成瘾戒毒人员中的适用性.方法:以460名甲基苯丙胺类成瘾的戒毒人员为施测对象,对数据进行项目分析、探索性因素分析和验证性因素分析.结果:修订版甲基苯丙胺渴求量表共包含5个因子,总量表与分量表的内部一致性系数0.62～0.73之间,重测信度...     

Executive Function, Neural Circuitry, and Genetic Mechanisms in Schizophrenia

After decades of research aimed at elucidating the pathophysiology and etiology of schizophrenia, it has become increasingly apparent that it is an illness knowing few boundaries. Psychopathological manifestations extend across several domains, impacting multiple facets of real-world functioning for the affected individual. Even within one such domain, arguably the most enduring, difficult to treat, and devastating to long-term functioning—executive impairment—there are not only a host of disrupted component processes, but also a complex underlying dysfunctional neural architecture. Further, just as implicated brain structures (eg, dorsolateral prefrontal cortex) through postmortem and neuroimaging techniques continue to show alterations in multiple, interacting signaling pathways, so too does evolving understanding of genetic risk factors suggest multiple molecular entry points to illness liability. With this expansive network of interactions in mind, the present chapter takes a systems-level approach to executive dysfunction in schizophrenia, by identifying key regions both within and outside of the frontal lobes that show changes in schizophrenia and are important in cognitive control neural circuitry, summarizing current knowledge of their relevant functional interactions, and reviewing emerging links between schizophrenia risk genetics and characteristic executive circuit aberrancies observed with neuroimaging methods.     

甲基苯丙胺的戒断反应与复吸

甲基苯丙胺（methamphetamine,MA）俗称冰毒,为苯丙胺类兴奋剂,是当前世界上广泛滥用的毒品之一。MA能增加单胺类神经递质如多巴胺、去甲肾上腺素、5羟色胺的释放,并阻断其再摄取,使突触间隙单胺类神经递质含量升高产生精神和身体作用。MA使用者会出现欣快、体能增加、性欲过强等症状。依赖者中断用药将发生戒断反应,主要包括睡眠混乱,情绪抑郁,焦虑,认知损伤,体能降低。戒断反应可分为两个时相：急性期（持续7～10d）和亚急性期（持续2周）。MA依赖者的复吸率颇高,预防复吸的发生具有极重要的实际意义。     

The Mediating Role of Impulsivity Between Psychological Distress and Alcohol Misuse Among College Students at a Historically Black University

Objective: Alcohol misuse is prevalent and clinically significant among college students. Psychological distress is one factor that has been found to predict alcohol misuse in this population. However, relatively few investigations examined the association of psychological distress to alcohol misuse or its underlying mechanisms among students attending historically Black colleges and universities (HBCUs). The present study examined whether impulsivity explains the relation between psychological distress and alcohol misuse in this population using structural equation modeling. Methods: Participants were 287 undergraduate students attending an HBCU in the southern United States (M_age = 22.5, 66.3% female, 93.7% Black). Results: Impulsivity was found to significantly mediate the association of psychological distress to alcohol misuse, such that higher levels of psychological distress were associated with greater impulsivity which, in turn, was related to more alcohol misuse. Further analyses indicated that attentional impulsivity significantly mediated the association of psychological distress to alcohol misuse. Conclusions: These findings suggest the utility of targeting impulsivity in interventions aimed at preventing and reducing alcohol misuse among college students attending HBCUs who experience psychological distress.     

The Prospective Effects of Impulsivity on Alcohol and Tobacco Use in a College Sample

Abstract

Alcohol and tobacco use are strongly associated, particularly in younger populations, and concurrent use may encourage progression toward dependence on both substances. Impulsivity has been linked to the use of alcohol and tobacco individually, but has not been studied in terms of its association with use of both. This study tested the hypothesis that the effects of impulsivity (sensation seeking and negative urgency) on smoking initiation in a sample of college students (n = 400) would be mediated by alcohol consumption. We also predicted that sensation seeking and negative urgency would predict alcohol and cigarette use and overlap among initiators.

Sensation seeking and negative urgency both predicted smoking initiation, but only the former effect was mediated by alcohol use. Among initiators, sensation seeking was associated with more frequent alcohol use as well as more frequent overlap between alcohol and tobacco use but not with smoking frequency. Higher negative urgency was associated with more frequent smoking, but not with alcohol use or alcohol/tobacco overlap. Findings are consistent with previous research in college samples and suggest the existence of multiple pathways to alcohol and tobacco use and co-use in college students.     

Inhibitory Control and Impulsivity Levels in Women Crack Users

Objective: investigate impulsivity levels and inhibitory control in women crack users and explore the relationships between impulsivity and inhibitory control. Method and Design: 52 healthy women (M = 32.83 years; SD = 9.54) and 46 crack cocaine users (M = 31.02 years; SD = 7.73), in abstinence, performed the assessment protocol included a Sociodemographic Data Questionnaire, Mini-Mental State Examination (MMSE), a GO/No-Go Task and the Barratt Impulsiveness Scale–11 (BIS-11). It was a quantitative research with cross-sectional design and control group. Results: crack group showed higher levels of impulsivity in all domains when compared to the control group (crack group M = 76.39, SD = 11.39, control group M = 58.53, SD = 10.76, p <.01). Participants from the crack group presented a significantly higher total reaction time in the Go-NoGo task (F(1,93) = 9.93, p =.002; effect size =.09, observed power =.87) and significantly more commission (F(1,93) = 7.20, p =.009; effect size =.07, observed power =.75) and omission errors (F(1,93) = 6.04, p =.01; effect size =.06, observed power =.68), in Go/NoGo Task. Groups did also significantly differ on total standard deviations suggesting that variability in total reaction time was significantly greater in the crack group. Results showed that only in the crack group there were significant correlations between Go-NoGo parameters and Barratt Impulsiveness Scale. Conclusions: Our findings are consistent that impulsivity and inhibitory control are closely linked to crack use in women. Future studies should consider to evaluate crack users in different withdrawal times, controlling the impact of abstinence time in the variables studied.     

The Role of Impulsivity Dimensions in the Relation Between Probable Posttraumatic Stress Disorder and Aggressive Behavior Among Substance Users

Objective: Individuals with co-occurring posttraumatic stress disorder (PTSD) and substance use disorder report heightened levels of numerous risky and health-compromising behaviors, including aggressive behaviors. Given evidence that aggressive behavior is associated with negative substance use disorder treatment outcomes, research is needed to identify the factors that may account for the association between PTSD and aggressive behavior among patients with substance use disorder. Thus, the goal of this study was to examine the role of impulsivity dimensions (i.e., negative urgency, lack of premeditation, lack of perseverance, and sensation seeking) in the relations between probable PTSD status and both verbal and physical aggression. Methods: Participants were 92 patients in residential substance use disorder treatment (75% male; 59% African American; M age = 40.25) who completed self-report questionnaires. Results: Patients with co-occurring PTSD–substance use disorder (vs. substance use disorder alone) reported significantly greater verbal and physical aggression as well as higher levels of negative urgency and lack of premeditation. Lack of premeditation and lack of perseverance were significantly positively associated with verbal aggression, whereas negative urgency, lack of premeditation, and lack of perseverance were significantly positively associated with physical aggression. The indirect relation of probable PTSD status to physical aggression through negative urgency was significant. Conclusions: Results highlight the potential utility of incorporating skills focused on controlling impulsive behaviors in the context of negative emotional arousal in interventions for physical aggression among patients with co-occurring PTSD–substance use disorder.